treatment vs enhancement

By “culture of biomedicine,” I am referring how biomedicine has cultivated a space for itself and become the dominant and most accepted form of medicine – at least in the Western world. It’s also about how biomedicine operates in terms of doctor/patient relationships, what we construct as health and disease, how we treat that, etc. Additionally as culture is dynamic, the culture of biomedicine too is dynamic. It’s always changing. It’s an important concept because it affects us. Biomedicine does not exist on a separate platform – the culture of biomedicine is something that we are a part of.

The dichotomy I chose to look at is the one between treatment and enhancement. Where do you draw the line between the two? What exactly is “enhancement”? For example, look at ADHD and Adderall (or Ritalin; or Vyvanse; etc). There are individuals out there who have ADHD and need Adderall to get them to even be able to focus. It puts them up to par with the rest of the neurotypical population – it gets them to “normal”. However, medications like Adderall are being used by individuals who don’t have ADHD to give them that extra edge. These non-ADHD Adderall users are now performing at a higher rate. So you have the ADHD individuals taking Adderall who are now performing at level X (or normal) and the non-ADHD individuals taking Adderall who are at level X+Y. This is clearly enhancement as those without ADHD who are taking Adderall are doing so to perform better than they could have without it. There are cases, however, where it isn’t so clear to me. When you look at biotechnologies, for instance, I feel that they are both treating and enhancing. LASIK surgery, for example, would be something one would get to correct their eyesight. However, it’s also enhancement because LASIK is not accessible to everyone.

I think this dichotomy is accepted because of its contested nature. It’s difficult to ascertain what exactly is enhancement and as long as that difficulty remains, this dichotomy shall exist and be accepted.